Univariate Analysis Of The Risk Factors Of Neonatal Tetanus

Objective: To investigate the risk factors of neonatal tetanus in orderto help prevent this catastrophic disease.Methods: A total of87neonates diagnosed with neonatal tetanus whowere admitted to Childrens’ hospital of Chongqing Medical Universityfrom January2000to January2010were enrolled in this study. Patientswere categorized into three groups according to the severity of theirdiseases. Data regarding perinatal history, clinical symptoms andintervention was collected retrospectively and analyzed using chi-squaretext.Results: Among the87patients,8were excluded due to withdrawal inmedical practice.26out of the79were dead while the other45fullyrecovered. None of the79patients was immunized with TAT either duringgestation or after birth. Most patients have a rural family background(percent?), and64of them were home delivered (90.1%). The gender ratioof female to male was1.4:1. The average birth weight was2780.77±6.65gand the average GA was? All patients presented clinical manifestations ofrisus sardonicus, rismus and limbshypermyotonia. The other symptoms and signs included dysphoria(95.8%), difficulty in opening mouth(91.5%),frequently convulsion(88.7%), opisthotonos(84.5%), feedingdifficulty(77.5%), dyspnea(73.2%), cyanosis9(69.1%), asphyxia(43.7%).According to the disease severity,25patients belong to the mild group(with a latent period beyond14d, with trismus and local myotonia),amongwho1gave up and1(4.2%,1/24) was dead.33patients belong to theintermediate group (with a latent period between7and14d, convulsionsymptoms including trismusand swallow difficulty and muotonia presented48h after onset), among who3cases gave up and9(30.0%,9/30) were dead;21cases were severe(incubation period below7d, convultion symptomsincluding trismus and muotonia along with severe spasm beyond controleasily presented in48h after onset),4in auto-discharge and15(94.2%,16/17) dead in this group. In cured group,23(51.5%,23/45)patients were mild,21(46.7%,21/45) were moderate,1(2.2%,1/45) wassevere. In death group,1(3.8%,1/26) was mild,9(34.6%,9/26) weremoderate,16(61.5%,16/26) were severe.Univariate analysis showed the potential risk factors includedgestational age，hospitalization time on treatment，onset time of diseas，latent period, duration of convulsion, hypothermia，antispasmodic doses,complications such as pneumonia, septicemia, asphyxia, hyperglycemia,scleredema， hyponatremia,increased CRP leve，thrombocytopenia.Conlusion: The risk factors associated with neonatal tetanus included gestational age，hospitalization time on treatment，onset time ofdiseas，latent period, duration of convulsion, hypothermia，antispasmodicdoses, complications such as pneumonia, septicemia, asphyxia,hyperglycemia, scleredema， hyponatremia,increased CRP leve，thrombocytopenia.Prevention of these factors may help reduce themortality of neonatal tetanus and improve neonatal included gestationalage，hospitalization time on treatment，onset time of diseas，latent period,duration of convulsion, hypothermia，antispasmodic doses, complicationssuch as pneumonia, septicemia, asphyxia, hyperglycemia, scleredema，hyponatremia,increased CRP leve，thrombocytopenia.